California County Health Status Profiles 2003

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COUNTY HEALTH STATUS

PROFILES2003

Health Information and Strategic PlanningGregory Franklin, M.P.H.

Deputy Director

Center for Health StatisticsMichael L. Rodrian, Chief

Office of Health Information and ResearchMichael Quinn, Chief

Planning and Data Analysis SectionKaren Flannigan, Chief

In collaboration withCalifornia Conference of Local Health OfficersPoki Stewart Namkung, M.D., M.P.H

President

Gray Davis

GovernorState of California

Grantland Johnson Diana M. Bont, R.N., Dr.P.H.Secretary DirectorCalifornia Health & Human Services Agency Department of Health Services


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ACKNOWLEDGMENTS

This report was prepared by Cynthia Schmidt, Research Program Specialist, and

Cheryl Wilson, Research Analyst, with the Center for Health Statistics, Planning and

Data Analysis Section. The principal authors would like to extend their appreciation tothe following people for their assistance in preparing this report:

Janet Ciarcia (Office of Health Information and Research) composed the formulaswithin the technical notes and coordinated the mass mailing of this report.

Michael Curtis (Maternal and Child Health Branch) provided breastfeeding initiationdata.

Denise Gilson (Division of Communicable Disease Control) provided syphilis andchlamydia case incidence data.

Mary Heim and Andrew Ruppenstein (Department of Finance) provided the 2000 andrace/ethnic population estimates by county with age and sex detail, December 1998 andthe 2000 census data.

Robert Poindexter(Office of AIDS) provided AIDS case incidence data.

Shu Sebesta (Division of Communicable Disease Control) provided hepatitis C caseincidence data.

Rina Shaikh (Division of Communicable Disease Control) provided measles case

incidence data.

Mich Tashiro (Office of Health Information and Research) matched the birth and infantdeath records from the separate Birth and Death Statistical Master Files to create theBirth Cohort-Perinatal Outcome Files of linked births and deaths.

Janice Westenhouse (Tuberculosis Control Program) provided tuberculosis caseincidence data.

The Staff of the Office of Vital Records collected, coded, and edited birth and deathcertificates, which form the basis of the Birth and Death Statistical Master Files.

Cover Photography by Penelope Cook: Mono Lake

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GRAY DAVISGovernor

State of CaliforniaHealth and Human Services Agency

Department of Health ServicesDIANA M. BONT, R.N., Dr. P.H.

Director

Dear Colleague:

We are pleased to present the eleventh edition ofCounty Health Status Profiles for PublicHealth Week, April 7 13, 2003. This report contains selected health status indicators

recommended by the U.S. Public Health Service for monitoring state and local progresstoward achieving some of the goals set forth in Health People 2010. The Healthy People2010 National Objectives challenge public health professionals to increase the span ofhealthy life, reduce health disparities, and ensure access to preventive services for allAmericans.

The Profiles report is evaluated with each annual edition and amended according topriorities developed by the Department of Health Services and the California Conference ofLocal Health officers. Data for chlamydia and hepatitis C were added in the 2001 report, asthey have emerged as public health concerns. However, the basic set of health indicatorsfrom year-to-year has remained relatively unchanged.

We believe this report represents an important means to assess public health in California.The health status indicators are based on data that are readily available for providinginformation to guide the future course of health promotion and preventive services.

Diana M. Bont, R.N., Dr. P.H. Poki Stewart Namkung, M.D., M.P.H.Director PresidentCalifornia Department of Health Services California Conference of Local Health Officers

Do your part to help California save energy. To learn more about saving energy, visit the following web site:www.consumerenergycenter.org/flex/index.html

1501 Capitol Avenue, P.O. Box 942732, Sacramento, CA, 94234-7320(916) 657-1425

Internet Address: www.dhs.ca.gov
http://www.dhs.ca.gov/http://www.dhs.ca.gov/http://www.dhs.ca.gov/http://www.dhs.ca.gov/


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TABLE OF CONTENTS

INTRODUCTION.....................................................................................................1- 2

TABLES WITH HIGHLIGHTS .................................................................................3-62

TABLES HEALTH STATUS INDICATORS

1 13 MORTALITY INDICATORS PER 100,000 POPULATION

1 All Causes of Death............................................................................................. 3-42 Motor Vehicle Crashes ........................................................................................ 5-63 Unintentional Injuries........................................................................................... 7-84 Firearm Injuries ................................................................................................... 9 -105 Homicide .............................................................................................................11-126 Suicide................................................................................................................. 13-147 All Cancer Deaths ............................................................................................... 15-168 Lung Cancer........................................................................................................ 17-189 Female Breast Cancer ........................................................................................ 19-20

10 Coronary Heart Disease...................................................................................... 21-2211 Cerebrovascular Disease (Stroke) ...................................................................... 23-2412 Drug-Related Deaths........................................................................................... 25-2613 Diabetes ..............................................................................................................27-28

14 19 MORBIDITY INDICATORS PER 100,000 POPULATION

14 Hepatitis C........................................................................................................... 29-3015 Acquired Immunodeficiency Syndrome (AIDS) ................................................... 31-3216 Tuberculosis ........................................................................................................ 33-3417 Chlamydia ...........................................................................................................35-3618 Syphilis ................................................................................................................ 3719 Measles ............................................................................................................... 38

20A 20E BIRTH COHORT INFANT MORTALITY UNDER ONE YEAROF AGE PER 1,000 LIVE BIRTHS

20A All Race/Ethnic Groups Infant Mortality............................................................... 39-4020B Asian/Other Race Group Infant Mortality ............................................................ 41-4220C Black Race Group Infant Mortality....................................................................... 43-4420D Hispanic Ethnic Group Infant Mortality ................................................................ 45-4620E White Race Group Infant Mortality ...................................................................... 47-48

21 23B NATALITY INDICATORS PER 100 LIVE BIRTHS OR 1,000

POPULATION

21 Low Birthweight Infants ....................................................................................... 49-5022 Births to Adolescent Mothers, 15-19 Years Old Per 1,000 Live Births................ 51-5223A Prenatal Care Not Begun During The First Trimester ......................................... 53-5423B Adequate/Adequate Plus Prenatal Care (APNCU Index).................................... 55-56

BREASTFEEDING INITIATION RATES PER 100 LIVE BIRTHS

24 Breastfeeding Initiation During Early Postpartum................................................ 57-58

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TABLE OF CONTENTS (continued)

TABLES HEALTH STATUS INDICATORS

2000 CENSUS POPULATION HEALTH INDICATOR

25 Persons Under 18 Below Poverty .......................................................................59-60

A COMPARISON OF THREE-YEAR AVERAGE DATA

26 A comparison of three-year average data among selected indicators ................ 61-62

TECHNICAL NOTES................................................................................................................... 63-74

Comparison of 1940 and 2000 Standard Population Age-Adjusted Rates(Appendix A)............................................................................................................................. 74

BIBLIOGRAPHY ........................................................................................................................... 75

ORDER FORMS........................................................................................................................... 76-78

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CALIFORNIACOUNTIES


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California Department of Health Services County Health Status Profiles 20031

INTRODUCTION

County Health Status Profiles has been presented annually for the State of California since1993. The purpose of this report is to present public health data that can be directlycompared with clearly established benchmarks, such as national standards, and

populations of similar composition.

In keeping with the goal of using national standards, two major changes were implementedin the 2001 report:

Mortality cause of death data were coded using the International Classification ofDiseases, Tenth Revision (reports prior to 2001 usedthe International Classificationof Diseases, Ninth Revision).

Age-adjusted rates use the 2000 Standard Population (reports prior to 2001 usedthe 1940 Standard Population).

The impact of these changes is discussed in the Technical Notes section of this report.

This report presents vital statistics and morbidity tables that show the population, number ofevents, percentages, crude rates, and age-adjusted death rates by county. Also shown onthese tables are the upper and lower 95 percent confidence limits, which provide a meansfor assessing the degree of stability of the estimated rates and percentages. Vital statisticsrates and percentages are also subject to random variation, which is inversely related tothe number of events (e.g., deaths) used to calculate the rates and percentages. Therefore,standard errors and relative standard errors (coefficients of variation) are calculated tomeasure the reliability of the rates and percentages. Estimated rates and percentages that

are categorized as unreliable (relative standard error 23 percent) are marked on thesetables with an asterisk ( * ). The counties on these tables are ranked by the rates or

percentages, regardless of their reliability, in ascending order. Those with identical rates orpercentages are ranked next by the countys population size in descending order.

The Highlightsand the explanatory Notes are adjacent to each of the tables. Theexplanatory Notes as well as the Technical Notes are provided to assist the readers withinformation on data limitations and qualifications for correctly interpreting and comparingthese data among the counties. For those who may want to learn more about the problemsassociated with analysis of vital events involving small numbers, small area analysis, andage-adjusted death rates, references to relevant statistical publications are located in theBibliography.

Data for this report have been provided by the California Department of Health ServicesCenter for Health Statistics, Division of Communicable Disease Control, Genetic DiseaseBranch, and the Office of AIDS. In addition, the Demographic Research Unit and theCensus Data Center of the Department of Finance provided the 2000 census data and the2000 race/ethnic population estimates by county with age and sex detail, December 1998.

You may access this report online at the California Department of Health Services webpage. The web page address for the index of publications where this report will be listedis:http://www.dhs.ca.gov/hisp/chs/OHIR/publication/publicationindex.htm
http://www.dhs.ca.gov/hisp/chs/OHIR/publication/publicationindex.htmhttp://www.dhs.ca.gov/hisp/chs/OHIR/publication/publicationindex.htmhttp://www.dhs.ca.gov/hisp/chs/OHIR/publication/publicationindex.htm


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If you have questions about this report, or desire additional state or county health statusdata and statistics (either hard copy reports or electronic media), please write or phone:

California Department of Health ServicesCenter for Health Statistics

1501 Capitol Avenue, 1st FloorP. O. Box 730241

Sacramento, CA 94244-0241

Telephone (916) 445-6355

Should you wish additional copies of County Health Status Profiles, instructions for placingyour order appear on page 76 of this report.


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1 MONO 10,891 42.7 391.8 486.5 * 187.5 785.5

2 ALPINE 1,239 5.7 457.4 * 520.1 * 0.0 1231.93 SAN BENITO 51,853 275.0 530.3 614.0 474.0 754.1

4 LASSEN 35,959 197.0 547.8 619.7 458.4 781.1

5 SAN MATEO 747,061 4,800.0 642.5 635.9 600.1 671.7

6 NEVADA 97,020 886.3 913.6 647.1 564.1 730.2

7 SIERRA 3,457 36.0 1,041.4 653.4 * 247.0 1059.8

8 SANTA CLARA 1,763,252 8,866.7 502.9 667.7 637.4 698.1

9 IMPERIAL 154,549 840.7 543.9 671.5 588.4 754.6

10 SANTA CRUZ 260,248 1,672.3 642.6 677.3 614.7 739.9

11 MARIPOSA 16,762 162.0 966.5 679.1 494.3 863.9

12 SAN FRANCISCO 792,049 6,534.0 824.9 681.5 651.6 711.3

13 COLUSA 20,973 145.0 691.4 683.8 484.5 883.0

14 SAN LUIS OBISPO 254,818 2,005.0 786.8 685.7 629.3 742.2

15 CALAVERAS 42,041 390.0 927.7 691.9 563.1 820.7

16 MODOC 10,481 98.0 935.0 703.5 448.3 958.6

17 EL DORADO 163,197 1,137.0 696.7 704.8 621.0 788.7

18 SANTA BARBARA 412,071 2,925.0 709.8 709.2 659.7 758.7

19 PLUMAS 20,852 209.7 1,005.5 709.3 530.0 888.7

20 MARIN 248,397 1,835.3 738.9 715.1 647.1 783.0

21 AMADOR 34,853 376.7 1,080.7 733.4 594.6 872.2

22 MONTEREY 401,886 2,396.0 596.2 737.1 678.5 795.8

23 INYO 18,437 199.7 1,083.0 740.6 555.1 926.1

24 DEL NORTE 31,155 252.3 809.9 741.4 585.9 896.8

25 VENTURA 753,820 4,687.7 621.9 742.5 699.7 785.4

26 CONTRA COSTA 931,946 6,691.7 718.0 752.6 716.4 788.8

27 MADERA 126,394 895.3 708.4 753.8 661.8 845.9

28 LOS ANGELES 9,838,861 59,473.3 604.5 755.8 743.9 767.8

29 SAN DIEGO 2,943,001 19,553.3 664.4 760.0 739.4 780.5

CALIFORNIA 34,653,395 229,678.7 662.8 760.0 753.9 766.0

30 ALAMEDA 1,470,155 9,810.3 667.3 762.6 733.3 791.9

31 SONOMA 459,258 3,814.0 830.5 766.7 720.2 813.3

32 RIVERSIDE 1,570,885 12,273.0 781.3 767.6 742.3 793.033 TUOLUMNE 56,125 570.3 1,016.2 771.7 649.4 894.1

34 NAPA 127,084 1,261.7 992.8 772.1 691.9 852.2

35 ORANGE 2,833,190 16,631.0 587.0 774.0 749.1 798.8

36 GLENN 29,298 241.0 822.6 774.0 599.2 948.8

37 BUTTE 207,158 2,166.0 1,045.6 774.2 715.7 832.7

38 SUTTER 82,040 676.7 824.8 795.5 684.7 906.4

39 PLACER 243,646 1,893.0 776.9 800.5 729.0 872.0

40 FRESNO 811,179 5,467.3 674.0 804.2 763.9 844.5

41 SAN JOAQUIN 579,712 4,340.7 748.8 809.4 765.3 853.5

42 TULARE 379,944 2,624.7 690.8 810.9 753.5 868.4

43 YOLO 164,010 1,093.0 666.4 814.8 723.2 906.5

44 KERN 677,372 4,713.7 695.9 823.9 780.6 867.2

45 KINGS 126,672 704.3 556.0 828.8 711.4 946.2

46 MENDOCINO 90,442 813.3 899.3 829.8 722.3 937.2

47 MERCED 215,256 1,365.3 634.3 829.9 743.8 916.0

48 SISKIYOU 45,194 487.3 1,078.3 835.4 695.1 975.649 TRINITY 13,490 139.7 1,035.3 837.9 583.8 1092.0

50 LAKE 60,072 750.0 1,248.5 839.8 737.3 942.4

51 SOLANO 399,841 2,471.7 618.2 843.1 774.1 912.2

52 SACRAMENTO 1,212,527 9,122.7 752.4 852.9 818.3 887.4

53 TEHAMA 56,666 622.7 1,098.8 857.8 738.1 977.5

54 STANISLAUS 459,025 3,444.0 750.3 860.8 806.7 915.0

55 SHASTA 175,777 1,702.7 968.7 861.7 784.0 939.3

56 SAN BERNARDINO 1,727,452 11,138.0 644.8 897.0 864.1 930.0

57 HUMBOLDT 128,419 1,218.3 948.7 939.2 841.1 1037.3

58 YUBA 63,983 533.0 833.0 1,008.2 851.0 1165.3

RANK

ORDER

TABLE 1

DEATHS DUE TO ALL CAUSES

RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATE

CALIFORNIA COUNTIES, 1999-2001

2000

1999-2001

LOWER UPPER

DEATHS CRUDE AGE-ADJUSTED 95% CONFIDENCE LIMITS

HEALTHY PEOPLE 2010 NATIONAL OBJECTIVE: NONE ESTABLISHED

(AVERAGE) DEATH RATE DEATH RATEPOPULATIONCOUNTY



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1 ALPINE 1,239 0.0 0.0 + 0.0 + - -HEALTHY PEOPLE 2010 NATIONAL OBJECTIVE: 17.5

2 LASSEN 35,959 6.0 16.7 * 18.2 * 3.5 32.9

3 SAN MATEO 747,061 144.0 19.3 19.1 16.0 22.2

4 SANTA CLARA 1,763,252 315.7 17.9 19.7 17.5 21.9

5 LOS ANGELES 9,838,861 2,003.0 20.4 21.8 20.9 22.8

6 MARIN 248,397 56.0 22.5 21.9 16.1 27.6

7 CONTRA COSTA 931,946 212.3 22.8 23.2 20.1 26.3

8 ORANGE 2,833,190 593.3 20.9 23.3 21.4 25.2

9 ALAMEDA 1,470,155 341.3 23.2 24.0 21.4 26.6

10 COLUSA 20,973 5.0 23.8 * 24.5 * 2.9 46.1

11 SANTA CRUZ 260,248 64.0 24.6 24.8 18.6 30.9

12 SOLANO 399,841 88.7 22.2 25.0 19.6 30.3

13 INYO 18,437 5.7 30.7 * 25.2 * 3.8 46.6

14 SAN DIEGO 2,943,001 733.0 24.9 26.5 24.6 28.5

34,653,395 9,009.3 26.0 27.2 26.6 27.7

15 SACRAMENTO 1,212,527 326.3 26.9 28.2 25.1 31.2

16 SONOMA 459,258 134.3 29.3 28.2 23.4 33.0

17 SAN BERNARDINO 1,727,452 440.3 25.5 28.3 25.6 31.018 YOLO 164,010 42.0 25.6 28.6 19.7 37.4

19 VENTURA 753,820 202.7 26.9 28.8 24.8 32.8

20 PLACER 243,646 70.0 28.7 29.0 22.2 35.9

21 NAPA 127,084 40.3 31.7 29.5 20.3 38.7

22 MONTEREY 401,886 113.3 28.2 30.6 24.9 36.3

23 SANTA BARBARA 412,071 131.7 32.0 31.7 26.3 37.1

24 RIVERSIDE 1,570,885 488.3 31.1 31.8 29.0 34.6

25 SAN BENITO 51,853 15.3 29.6 * 32.1 * 15.9 48.2

26 SAN FRANCISCO 792,049 281.3 35.5 32.3 28.4 36.1

27 NEVADA 97,020 35.0 36.1 32.6 21.4 43.8

28 SAN LUIS OBISPO 254,818 84.0 33.0 33.0 25.8 40.2

29 EL DORADO 163,197 55.3 33.9 34.5 25.3 43.6

30 AMADOR 34,853 14.3 41.1 * 36.2 * 16.7 55.8

31 MODOC 10,481 4.7 44.5 * 37.1 * 2.5 71.7

32 SAN JOAQUIN 579,712 211.3 36.5 37.8 32.7 42.933 IMPERIAL 154,549 69.0 44.6 38.3 27.6 49.0

34 FRESNO 811,179 298.7 36.8 39.9 35.3 44.4

35 BUTTE 207,158 87.7 42.3 40.1 31.5 48.6

36 PLUMAS 20,852 9.7 46.4 * 41.6 * 14.1 69.2

37 KERN 677,372 265.3 39.2 41.7 36.7 46.8

38 STANISLAUS 459,025 187.0 40.7 43.0 36.8 49.2

39 SUTTER 82,040 35.7 43.5 43.6 29.2 57.9

40 TUOLUMNE 56,125 26.7 47.5 43.9 27.0 60.9

41 KINGS 126,672 49.0 38.7 44.2 31.4 57.1

42 MONO 10,891 4.7 42.8 * 44.4 * 2.5 86.4

43 MERCED 215,256 85.7 39.8 44.5 34.9 54.2

44 MENDOCINO 90,442 41.3 45.7 44.6 30.9 58.3

45 TEHAMA 56,666 28.3 50.0 45.6 28.3 62.9

46 MADERA 126,394 56.7 44.8 46.3 34.1 58.4

47 TULARE 379,944 169.3 44.6 47.5 40.3 54.8

48 GLENN 29,298 14.3 48.9 * 49.4 * 23.6 75.3

49 SISKIYOU 45,194 25.3 56.1 50.2 30.0 70.4

50 SHASTA 175,777 89.3 50.8 50.7 40.1 61.3

51 MARIPOSA 16,762 10.0 59.7 * 53.8 * 18.9 88.7

52 DEL NORTE 31,155 17.0 54.6 * 53.9 * 28.1 79.8

53 SIERRA 3,457 2.7 77.1 * 54.0 * 0.0 120.1

54 YUBA 63,983 31.7 49.5 54.5 35.3 73.6

55 HUMBOLDT 128,419 72.7 56.6 55.2 42.5 67.9

56 CALAVERAS 42,041 25.3 60.3 57.1 34.0 80.3

57 LAKE 60,072 38.3 63.8 62.0 41.5 82.6

58 TRINITY 13,490 9.3 69.2 * 66.0 * 22.4 109.7

RANK

ORDER

TABLE 3

DEATHS DUE TO UNINTENTIONAL INJURIES



2000

1999-2001

LOWER

DEATHS CRUDE AGE-ADJUSTED 95% CONFIDENCE LIMITS

CALIFORNIA

POPULATION UPPER(AVERAGE) DEATH RATE DEATH RATECOUNTY



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TABLE 5: DEATHS DUE TO HOMICIDE, 1999-2001

California Counties Ranked by Three-Year Average Age-Adjusted Death Rate

The crude death rate from homicide for California was 6.2 per 100,000population, a risk of dying equivalent to approximately one death for every

16,176 persons. This rate was based on a three-year average number ofdeaths from 1999 to 2001 of 2,142.3 and a population of 34,653,395 as ofJuly 1, 2000. Among counties with "reliable" rates, the crude rate ranged from10.1 in Los Angeles County to 2.2 in Santa Clara County, a difference in ratesby a factor of 4.6 to 1.

The age-adjusted death rate from homicide for California for the three-yearperiod from 1999 to 2001 was 6.2 per 100,000 population. Reliableage-adjusted death rates ranged from 10.4 in Los Angeles County to 2.2 in

Santa Clara County. The difference between crude and age-adjusted ratesshows how the county age composition differs from the 2000 United Statespopulation.

Altogether 23 counties (2 with reliable age-adjusted death rates), but notCalifornia as a whole, met the Healthy People 2010 National Objective of nomore than 3.0 age-adjusted deaths due to homicide per 100,000 population.

Notes:

Death rates are per 100,000 population. The crude death rate is the actual risk of dying. The age-adjustedrate is the hypothetical rate that the State/County would have if its population were distributed by age in thesame proportions as the 2000 United States population.

* Death rate unreliable, relative standard error is greater than or equal to 23 percent.+ Standard error indeterminate, death rate based on no (zero) deaths.- Upper and lower limits at the 95 percent confidence level are not calculated for no (zero) deaths.

Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard error ofgreater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.The wider the interval, the less precise the death rate. The upper and lower limits define the range withinwhich the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.

(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES

Department of Health Services: Death Statistical Master Files, 1999-2001.Department of Finance: 2000 Population Estimates with Age, Sex and Race/Ethnic Detail, December 1998.


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TABLE 6: DEATHS DUE TO SUICIDE, 1999-2001


The crude death rate from suicide for California was 9.1 per 100,000population, a risk of dying equivalent to approximately one death for every

11,041 persons. This rate was based on a three-year average number ofdeaths from 1999 to 2001 of 3,138.7 and a population of 34,653,395 as ofJuly 1, 2000. Among counties with "reliable" rates, the crude rate ranged from19.5 in Shasta County to 6.7 in Monterey County, a difference in rates by afactor of 2.9 to 1.

The age-adjusted death rate from suicide for California for the three-yearperiod from 1999 to 2001 was 9.5 per 100,000 population. Reliableage-adjusted death rates ranged from 19.4 in Shasta County to 7.1 in

Santa Clara County. The difference between the crude rate and theage-adjusted rate shows how the county age composition differs from the2000 United States population.

None of the counties, nor California as a whole, met the Healthy People 2010National Objective of no more than 5.0 age-adjusted deaths due to suicide per100,000 population.

Notes:


* Death rate unreliable, relative standard error is greater than or equal to 23 percent.

Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard error ofgreater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.The wider the interval, the less precise the death rate. The upper and lower limits define the range withinwhich the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES



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TABLE 9: DEATHS DUE TO FEMALE BREAST CANCER, 1999-2001


The crude death rate from female breast cancer for California was 25.6 per100,000 population, a risk of dying equivalent to approximately one death for

every 3,901 females. This rate was based on a three-year average number ofdeaths of 4,149.0 from 1999 to 2001 and a female population of 16,186,182as of July 1, 2000. Among counties with "reliable" rates, the crude rate rangedfrom 50.1 in Humboldt County to 21.1 in Tulare County, a difference in ratesby a factor of 2.4 to 1.

The age-adjusted death rate from female breast cancer for California for thethree-year period from 1999 to 2001 was 24.5 per 100,000 population.Reliable age-adjusted death rates ranged from 41.8 in Humboldt County to

18.6 in San Francisco County. The difference between crude andage-adjusted rates shows how the county age composition differs from the2000 United States population.

Altogether 17 counties (6 with reliable age-adjusted death rates), but notCalifornia as a whole, met the Healthy People 2010 National Objective of nomore than 22.3 age-adjusted deaths due to female breast cancer per 100,000population.

Notes:

Death rates are per 100,000 female population. The crude death rate is the actual risk of dying. Theage-adjusted rate is the hypothetical rate that the State/County would have if its population were distributed byage in the same proportions as the 2000 United States population.


Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard error ofgreater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.The wider the interval, the less precise the death rate. The upper and lower limits define the range withinwhich the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES



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1 ALPINE 557 0.0 0.0 + 0.0 + - -

2 SIERRA 1,606 0.3 20.8 * 8.0 * 0.0 35.0

3 DEL NORTE 13,275 2.0 15.1 * 11.4 * 0.0 27.6

4 MONO 4,777 0.7 14.0 * 13.0 * 0.0 44.7

5 COLUSA 9,345 1.3 14.3 * 13.3 * 0.0 35.8

6 MADERA 59,126 8.7 14.7 * 13.5 * 4.5 22.5

7 LASSEN 12,993 2.3 18.0 * 14.4 * 0.0 33.0

8 SAN FRANCISCO 381,013 95.7 25.1 18.6 14.8 22.4

9 MODOC 4,732 1.3 28.2 * 20.0 * 0.0 56.2

10 SANTA BARBARA 189,135 43.3 22.9 20.1 14.0 26.1

11 CALAVERAS 19,960 6.3 31.7 * 20.3 * 4.3 36.2

12 SANTA CRUZ 121,894 28.0 23.0 20.4 12.7 28.0

13 NEVADA 46,115 15.0 32.5 * 20.4 * 9.7 31.0

14 LAKE 28,869 9.0 31.2 * 21.3 * 6.8 35.8

15 SANTA CLARA 817,347 177.3 21.7 21.6 18.4 24.8

16 TULARE 175,512 37.0 21.1 21.9 14.8 29.0

17 EL DORADO 76,393 20.0 26.2 22.3 12.5 32.122.3

18 IMPERIAL 68,789 14.3 20.8 * 22.5 * 10.8 34.119 MONTEREY 179,280 40.7 22.7 22.5 15.6 29.5

20 FRESNO 379,983 83.3 21.9 22.6 17.7 27.5

21 SAN LUIS OBISPO 113,043 32.7 28.9 22.6 14.6 30.7

22 NAPA 60,010 18.3 30.6 * 22.7 * 12.1 33.4

23 SISKIYOU 21,330 7.0 32.8 * 23.2 * 5.5 40.8

24 SAN BENITO 23,788 5.7 23.8 * 23.4 * 4.1 42.7

25 SAN MATEO 356,983 101.0 28.3 23.5 18.9 28.1

26 KINGS 53,248 10.7 20.0 * 23.5 * 9.4 37.6

27 LOS ANGELES 4,626,142 1,074.0 23.2 23.6 22.2 25.0

28 ORANGE 1,321,942 309.0 23.4 23.8 21.1 26.4

29 BUTTE 99,518 32.0 32.2 23.9 15.3 32.4

30 STANISLAUS 216,432 52.3 24.2 23.9 17.4 30.4

31 AMADOR 15,169 6.0 39.6 * 24.1 * 4.2 44.0

32 SUTTER 38,595 11.0 28.5 * 24.1 * 9.8 38.5

33 KERN 309,126 73.0 23.6 24.4 18.8 30.116,186,182 4,149.0 25.6 24.5 23.8 25.3

34 TEHAMA 26,878 9.3 34.7 * 25.0 * 8.6 41.5

35 ALAMEDA 698,469 189.3 27.1 25.1 21.5 28.7

36 MENDOCINO 42,041 13.3 31.7 * 25.4 * 11.7 39.0

37 CONTRA COSTA 443,425 131.7 29.7 25.4 21.0 29.7

38 RIVERSIDE 736,957 215.0 29.2 26.0 22.5 29.5

39 SHASTA 83,527 28.3 33.9 26.0 16.4 35.7

40 SAN JOAQUIN 266,330 73.0 27.4 26.5 20.4 32.6

41 TUOLUMNE 24,876 9.7 38.9 * 26.6 * 9.3 43.8

42 SAN BERNARDINO 802,259 192.3 24.0 27.0 23.2 30.9

43 YUBA 29,872 7.7 25.7 * 27.3 * 7.9 46.6

44 VENTURA 348,734 99.7 28.6 27.3 21.9 32.7

45 SAN DIEGO 1,343,931 377.3 28.1 27.4 24.6 30.2

46 SACRAMENTO 578,490 171.3 29.6 27.9 23.7 32.1

47 MERCED 98,791 25.3 25.6 28.0 17.1 38.9

48 SOLANO 182,577 50.0 27.4 28.2 20.3 36.1

49 PLACER 115,181 38.0 33.0 28.6 19.5 37.7

50 SONOMA 219,639 78.3 35.7 28.7 22.3 35.1

51 GLENN 13,415 4.3 32.3 * 29.2 * 1.2 57.1

52 INYO 8,753 3.7 41.9 * 30.6 * 0.0 64.2

53 YOLO 73,064 21.7 29.7 30.7 17.7 43.7

54 TRINITY 6,205 3.0 48.3 * 32.0 * 0.0 68.5

55 MARIN 118,638 47.0 39.6 33.4 23.8 43.0

56 MARIPOSA 7,867 4.3 55.1 * 38.3 * 1.1 75.5

57 PLUMAS 9,695 5.7 58.4 * 38.4 * 6.0 70.7

58 HUMBOLDT 60,541 30.3 50.1 41.8 26.8 56.7

2000 1999-2001

LOWER

TABLE 9

DEATHS DUE TO FEMALE BREAST CANCER

RANKED BY THREE-YEAR AVERAGE AGE-ADJUSTED DEATH RATES


DEATH RATE UPPER

DEATHSRANK

ORDER POPULATIONCOUNTY

AGE-ADJUSTED 95% CONFIDENCE LIMITSFEMALE

CALIFORNIA

(AVERAGE) DEATH RATE

CRUDE

HEALTHY PEOPLE 2010 NATIONAL OBJECTIVE



29/87


30/87


31/87


TABLE 11: DEATHS DUE TO CEREBROVASCULAR DISEASE(STROKE), 1999-2001


The crude death rate from cerebrovascular disease for California was 52.2 per100,000 population, a risk of dying equivalent to approximately one death forevery 1,916 persons. This rate was based on a three-year average number ofdeaths of 18,082.3 from 1999 to 2001 and a population of 34,653,395 as ofJuly 1, 2000. Among counties with "reliable" rates, the crude rate ranged from114.3 in Lake County to 36.0 in Imperial County, a difference in rates by afactor of 3.2 to 1.

The age-adjusted death rate from cerebrovascular disease for California forthe three-year period from 1999 to 2001 was 61.2 per 100,000 population.

Reliable age-adjusted death rates ranged from 87.4 in Yuba County to 45.1 inEl Dorado County. The difference between crude and age-adjusted ratesshows how the county age composition differs from the 2000 United Statespopulation.

Altogether 14 counties (5 with a reliable age-adjusted death rate), but notCalifornia as a whole, met the Healthy People 2010 National Objective of nomore than 48.0 age-adjusted deaths due to cerebrovascular disease per100,000 population.

Notes:Death rates are per 100,000 population. The crude death rate is the actual risk of dying. The age-adjustedrate is the hypothetical rate that the State/County would have if its population were distributed by age in thesame proportions as the 2000 United States population.

* Death rate unreliable, relative standard error is greater than or equal to 23 percent.

Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard error ofgreater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.The wider the interval, the less precise the death rate. The upper and lower limits define the range within

which the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES



32/87

1 SIERRA 3,457 1.7 48.2 * 26.2 * 0.0 66.1

2 COLUSA 20,973 7.3 35.0 * 33.8 * 9.3 58.4

3 MONO 10,891 2.7 24.5 * 34.5 * 0.0 76.9

4 ALPINE 1,239 0.3 26.9 * 34.8 * 0.0 152.8

5 PLUMAS 20,852 11.0 52.8 * 35.0 * 14.2 55.8

6 LASSEN 35,959 13.0 36.2 * 41.2 * 18.8 63.6

7 DEL NORTE 31,155 16.0 51.4 * 44.0 * 22.4 65.7

8 MARIPOSA 16,762 11.7 69.6 * 44.8 * 18.9 70.6

9 EL DORADO 163,197 70.3 43.1 45.1 34.5 55.8

10 TUOLUMNE 56,125 36.0 64.1 45.2 30.3 60.0

11 INYO 18,437 13.7 74.1 * 45.9 * 21.4 70.4

12 SAN BENITO 51,853 20.3 39.2 46.5 26.3 66.8

13 IMPERIAL 154,549 55.7 36.0 47.2 34.8 59.6

14 MADERA 126,394 56.7 44.8 47.9 35.4 60.348.0

15 SANTA CRUZ 260,248 120.3 46.2 48.9 40.1 57.7

16 CALAVERAS 42,041 29.0 69.0 49.2 31.0 67.3

17 SAN LUIS OBISPO 254,818 162.7 63.8 52.3 44.2 60.4

18 SHASTA 175,777 109.7 62.4 54.4 44.2 64.619 SISKIYOU 45,194 33.3 73.8 54.6 36.0 73.3

20 RIVERSIDE 1,570,885 902.3 57.4 55.4 51.7 59.0

21 KERN 677,372 311.3 46.0 55.7 49.5 61.9

22 TRINITY 13,490 9.7 71.7 * 57.1 * 20.8 93.4

23 SAN FRANCISCO 792,049 574.7 72.6 57.2 52.5 61.9

24 LOS ANGELES 9,838,861 4,368.0 44.4 57.5 55.8 59.3

25 BUTTE 207,158 182.0 87.9 58.1 49.6 66.7

26 TEHAMA 56,666 44.3 78.2 58.1 40.9 75.4

27 SANTA CLARA 1,763,252 735.7 41.7 59.6 55.3 64.0

28 AMADOR 34,853 32.0 91.8 60.1 39.1 81.2

29 SAN DIEGO 2,943,001 1,567.0 53.2 61.1 58.0 64.1

34,653,395 18,082.3 52.2 61.2 60.3 62.1

30 SANTA BARBARA 412,071 258.0 62.6 61.3 53.8 68.7

31 SAN BERNARDINO 1,727,452 716.7 41.5 61.3 56.8 65.8

32 TULARE 379,944 198.3 52.2 61.7 53.1 70.333 NEVADA 97,020 90.3 93.1 62.8 49.8 75.9

34 SAN MATEO 747,061 471.7 63.1 63.0 57.3 68.6

35 MODOC 10,481 9.7 92.2 * 63.3 * 23.2 103.3

36 MONTEREY 401,886 199.7 49.7 63.3 54.5 72.1

37 FRESNO 811,179 427.0 52.6 63.7 57.6 69.7

38 VENTURA 753,820 389.0 51.6 64.3 57.9 70.7

39 STANISLAUS 459,025 255.3 55.6 64.6 56.7 72.5

40 HUMBOLDT 128,419 85.0 66.2 65.0 51.2 78.9

41 MENDOCINO 90,442 65.0 71.9 65.0 49.2 80.9

42 ORANGE 2,833,190 1,322.3 46.7 65.1 61.6 68.6

43 GLENN 29,298 21.0 71.7 65.2 37.2 93.2

44 LAKE 60,072 68.7 114.3 65.3 49.6 80.9

45 KINGS 126,672 53.0 41.8 66.5 48.6 84.5

46 PLACER 243,646 155.0 63.6 66.6 56.1 77.1

47 YOLO 164,010 90.0 54.9 66.9 53.1 80.8

48 SUTTER 82,040 58.3 71.1 67.8 50.3 85.2

49 ALAMEDA 1,470,155 853.3 58.0 68.2 63.6 72.7

50 SONOMA 459,258 349.0 76.0 68.4 61.2 75.6

51 MERCED 215,256 109.0 50.6 69.4 56.4 82.5

52 CONTRA COSTA 931,946 618.7 66.4 71.6 66.0 77.3

53 SACRAMENTO 1,212,527 748.3 61.7 72.1 67.0 77.3

54 SAN JOAQUIN 579,712 392.3 67.7 72.6 65.4 79.8

55 MARIN 248,397 186.0 74.9 73.1 62.6 83.6

56 NAPA 127,084 132.7 104.4 76.4 63.3 89.5

57 SOLANO 399,841 215.7 53.9 79.8 69.1 90.6

58 YUBA 63,983 45.0 70.3 87.4 61.8 113.0

CALIFORNIA

UPPER

95% CONFIDENCE LIMITSRANK

ORDER

2000

(AVERAGE)

DEATHS


TABLE 11

DEATHS DUE TO CEREBROVASCULAR DISEASE



1999-2001

LOWERCOUNTY

CRUDE AGE-ADJUSTED

DEATH RATE DEATH RATEPOPULATION



33/87


TABLE 12: DRUG-RELATED DEATHS, 1999-2001


The crude death rate from drug-related deaths for California was 8.3 per100,000 population, a risk of dying equivalent to approximately one death for

every 12,100 persons. This rate was based on a three-year average numberof deaths of 2,864.0 from 1999 to 2001 and a population of 34,653,395 as ofJuly 1, 2000. Among counties with "reliable" rates, the crude rate ranged from23.6 in Humboldt County to 4.0 in Santa Clara County, a difference in rates bya factor of 5.9 to 1.

The age-adjusted death rate from drug-related deaths for California for thethree-year period from 1999 to 2001 was 8.4 per 100,000 population. Reliableage-adjusted death rates ranged from 22.8 in Humboldt County to 3.8 in

Santa Clara County. The difference between crude and age-adjusted ratesshows how the county age composition differs from the 2000 United Statespopulation.

Altogether one county (none with a reliable age-adjusted death rate), but notCalifornia as a whole, met the Healthy People 2010 National Objective of nomore than 1.0 age-adjusted drug-related death per 100,000 population.

Notes:



Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard errorof greater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.The wider the interval, the less precise the death rate. The upper and lower limits define the range withinwhich the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES



34/87

1 ALPINE 1,239 0.0 0.0 + 0.0 + - -1.0

2 MONO 10,891 0.3 3.1 * 2.3 * 0.0 10.3

3 GLENN 29,298 0.7 2.3 * 2.8 * 0.0 9.4

4 INYO 18,437 0.7 3.6 * 3.2 * 0.0 10.9

5 SANTA CLARA 1,763,252 70.3 4.0 3.8 2.9 4.8

6 SAN BENITO 51,853 2.3 4.5 * 4.9 * 0.0 11.2

7 AMADOR 34,853 2.0 5.7 * 5.4 * 0.0 12.9

8 PLACER 243,646 13.3 5.5 * 5.6 * 2.6 8.6

9 SUTTER 82,040 4.7 5.7 * 5.9 * 0.5 11.4

10 PLUMAS 20,852 1.3 6.4 * 6.1 * 0.0 16.6

11 SAN MATEO 747,061 49.7 6.6 6.4 4.6 8.2

12 NAPA 127,084 8.7 6.8 * 6.4 * 2.1 10.7

13 LASSEN 35,959 2.3 6.5 * 6.7 * 0.0 15.4

14 SOLANO 399,841 27.7 6.9 7.0 4.3 9.6

15 CONTRA COSTA 931,946 67.0 7.2 7.0 5.3 8.7

16 ORANGE 2,833,190 203.3 7.2 7.2 6.2 8.2

17 COLUSA 20,973 1.3 6.4 * 7.3 * 0.0 19.6

18 LOS ANGELES 9,838,861 718.7 7.3 7.4 6.9 7.919 NEVADA 97,020 7.3 7.6 * 7.4 * 1.9 13.0

20 SACRAMENTO 1,212,527 90.0 7.4 7.4 5.9 9.0

21 MONTEREY 401,886 29.0 7.2 7.7 4.9 10.5

22 SIERRA 3,457 0.3 9.6 * 7.8 * 0.0 34.4

23 MERCED 215,256 14.7 6.8 * 8.0 * 3.9 12.1

24 ALAMEDA 1,470,155 124.3 8.5 8.2 6.7 9.6

25 YOLO 164,010 11.0 6.7 * 8.2 * 3.3 13.2

26 MADERA 126,394 9.7 7.6 * 8.4 * 3.0 13.7

34,653,395 2,864.0 8.3 8.4 8.1 8.7

27 FRESNO 811,179 61.7 7.6 8.5 6.4 10.6

28 EL DORADO 163,197 14.3 8.8 * 8.8 * 4.2 13.4

29 VENTURA 753,820 66.0 8.8 8.9 6.7 11.0

30 RIVERSIDE 1,570,885 131.0 8.3 8.9 7.4 10.5

31 MARIPOSA 16,762 1.7 9.9 * 9.0 * 0.0 23.5

32 KINGS 126,672 9.7 7.6 * 9.0 * 3.3 14.833 SONOMA 459,258 45.0 9.8 9.2 6.5 12.0

34 SANTA BARBARA 412,071 37.7 9.1 9.3 6.3 12.3

35 SAN BERNARDINO 1,727,452 152.7 8.8 9.4 7.9 10.9

36 TUOLUMNE 56,125 5.3 9.5 * 9.4 * 1.4 17.4

37 MODOC 10,481 1.0 9.5 * 9.7 * 0.0 28.9

38 TRINITY 13,490 1.0 7.4 * 9.7 * 0.0 28.7

39 SAN DIEGO 2,943,001 259.0 8.8 9.7 8.5 10.9

40 IMPERIAL 154,549 13.0 8.4 * 9.9 * 4.4 15.3

41 SANTA CRUZ 260,248 26.7 10.2 9.9 6.1 13.7

42 MARIN 248,397 27.0 10.9 10.2 6.3 14.0

43 TULARE 379,944 33.7 8.9 10.2 6.7 13.6

44 BUTTE 207,158 20.0 9.7 10.3 5.7 14.8

45 SISKIYOU 45,194 5.0 11.1 * 11.1 * 1.1 21.1

46 CALAVERAS 42,041 4.0 9.5 * 11.2 * 0.0 22.3

47 SAN JOAQUIN 579,712 61.0 10.5 11.2 8.4 14.0

48 SAN LUIS OBISPO 254,818 27.7 10.9 11.9 7.4 16.4

49 TEHAMA 56,666 6.7 11.8 * 12.8 * 3.0 22.6

50 MENDOCINO 90,442 12.0 13.3 * 13.3 * 5.7 20.9

51 YUBA 63,983 7.7 12.0 * 13.6 * 3.9 23.3

52 KERN 677,372 84.7 12.5 13.7 10.8 16.6

53 STANISLAUS 459,025 60.3 13.1 14.1 10.5 17.6

54 SHASTA 175,777 25.3 14.4 15.4 9.4 21.4

55 SAN FRANCISCO 792,049 153.7 19.4 17.4 14.6 20.2

56 LAKE 60,072 11.3 18.9 * 20.5 * 8.3 32.8

57 HUMBOLDT 128,419 30.3 23.6 22.8 14.7 31.0

58 DEL NORTE 31,155 7.3 23.5 * 25.5 * 7.0 44.0

1999-2001

LOWERCOUNTY

DEATHS CRUDE AGE-ADJUSTED

(AVERAGE) DEATH RATE DEATH RATEPOPULATION

TABLE 12

DRUG-RELATED DEATHS



CALIFORNIA

UPPER

95% CONFIDENCE LIMITSRANK

ORDER

2000


California Department of Health Services 26 County Health Status Profiles 2003


35/87


TABLE 13:DEATHS DUE TO DIABETES, 1999-2001


The crude death rate from diabetes for California was 18.0 per 100,000population, a risk of dying equivalent to approximately one death for every

5,570 persons. This rate was based on a three-year average number ofdeaths of 6,221.3 from 1999 to 2001 and a population of 34,653,395 as ofJuly 1, 2000. Among counties with "reliable" rates, the crude rate ranged from35.3 in Tehama County to 10.3 in Marin County, a difference in rates by afactor of 3.4 to 1.

The age-adjusted death rate from diabetes for California for the three-yearperiod from 1999 to 2001 was 20.7 per 100,000 population. Reliableage-adjusted death rates ranged from 48.4 in Kings County to 9.8 in

Marin County. The difference between crude and age-adjusted rates showshow the county age composition differs from the 2000 United Statespopulation.

The Healthy People 2010 National Objective for diabetes mortality is based onboth underlying and contributing causes of death. Multiple cause of deathdata for 2000 are not yet available for California. Therefore, Californiasprogress in meeting this objective will not be addressed in this report.

Notes:Death rates are per 100,000 population. The crude death rate is the actual risk of dying. The age-adjustedrate is the hypothetical rate that the State/County would have if its population were distributed by age in thesame proportions as the 2000 United States population.


Counties were rank ordered first by increasing age-adjusted death rate (calculated to 15 decimal places),second by decreasing size of the population. For purposes of this report, rates with a relative standard error ofgreater than or equal to 23 percent are considered unreliable. The upper and lower limits of theage-adjusted death rate at the 95 percent confidence level indicate the precision of the estimated death rate.

The wider the interval, the less precise the death rate. The upper and lower limits define the range withinwhich the death rate probably would occur in 95 out of 100 independent sets of data similar to the present set.(For additional information see the Technical Notes, pages 63 through 74.)

DATA SOURCES



36/87

1 ALPINE 1,239 0.0 0.0 + 0.0 + - -

2 CALAVERAS 42,041 5.0 11.9 * 8.7 * 0.8 16.6

3 AMADOR 34,853 5.3 15.3 * 9.8 * 1.4 18.1

4 MARIN 248,397 25.7 10.3 9.8 6.0 13.6

5 NEVADA 97,020 13.0 13.4 * 10.1 * 4.4 15.7

6 TUOLUMNE 56,125 8.0 14.3 * 11.0 * 3.3 18.7

7 LASSEN 35,959 3.7 10.2 * 11.8 * 0.0 23.8

8 COLUSA 20,973 2.3 11.1 * 12.0 * 0.0 27.4

9 SUTTER 82,040 10.3 12.6 * 12.3 * 4.8 19.8

10 PLUMAS 20,852 3.3 16.0 * 12.4 * 0.0 26.1

11 MARIPOSA 16,762 3.3 19.9 * 13.1 * 0.0 27.4

12 DEL NORTE 31,155 4.7 15.0 * 13.5 * 1.2 25.9

13 SAN MATEO 747,061 103.3 13.8 13.5 10.9 16.2

14 INYO 18,437 3.7 19.9 * 13.6 * 0.0 27.7

15 SAN LUIS OBISPO 254,818 41.0 16.1 14.3 9.8 18.7

16 SAN FRANCISCO 792,049 136.7 17.3 14.4 12.0 16.8

17 SAN BENITO 51,853 6.3 12.2 * 14.5 * 3.2 25.7

18 PLACER 243,646 35.7 14.6 15.1 10.1 20.0

19 SIERRA 3,457 0.7 19.3 * 15.1 * 0.0 51.320 MODOC 10,481 2.3 22.3 * 15.1 * 0.0 34.8

21 BUTTE 207,158 44.3 21.4 15.8 11.0 20.6

22 EL DORADO 163,197 26.3 16.1 15.9 9.8 22.0

23 SANTA BARBARA 412,071 64.0 15.5 16.0 12.1 19.9

24 MONO 10,891 1.3 12.2 * 16.1 * 0.0 44.5

25 SONOMA 459,258 79.7 17.3 16.4 12.8 20.1

26 RIVERSIDE 1,570,885 259.7 16.5 16.6 14.5 18.6

27 CONTRA COSTA 931,946 153.0 16.4 16.9 14.2 19.6

28 SANTA CRUZ 260,248 41.3 15.9 17.3 12.0 22.6

29 SANTA CLARA 1,763,252 236.3 13.4 17.5 15.2 19.8

30 SAN DIEGO 2,943,001 449.7 15.3 17.7 16.1 19.4

31 ORANGE 2,833,190 404.0 14.3 18.4 16.6 20.2

32 GLENN 29,298 5.7 19.3 * 18.7 * 3.2 34.3

33 NAPA 127,084 29.7 23.3 18.8 11.9 25.6

34 SISKIYOU 45,194 11.3 25.1 * 19.0 * 7.8 30.235 MONTEREY 401,886 63.0 15.7 19.6 14.8 24.5

36 LAKE 60,072 19.0 31.6 20.1 * 10.8 29.4

37 SACRAMENTO 1,212,527 223.3 18.4 20.7 17.9 23.4

34,653,395 6,221.3 18.0 20.7 20.2 21.2

38 SHASTA 175,777 42.0 23.9 21.1 14.7 27.5

39 ALAMEDA 1,470,155 282.3 19.2 22.1 19.5 24.7

40 MENDOCINO 90,442 21.7 24.0 22.1 12.8 31.5

41 VENTURA 753,820 139.7 18.5 22.3 18.6 26.0

42 YOLO 164,010 29.7 18.1 22.5 14.4 30.6

43 SOLANO 399,841 66.0 16.5 22.8 17.2 28.4

44 KERN 677,372 129.7 19.1 23.0 19.0 26.9

45 TRINITY 13,490 4.0 29.7 * 23.6 * 0.0 47.3

46 LOS ANGELES 9,838,861 1,863.0 18.9 23.9 22.8 25.0

47 IMPERIAL 154,549 29.7 19.2 24.8 15.9 33.8

48 STANISLAUS 459,025 98.7 21.5 25.1 20.1 30.149 SAN JOAQUIN 579,712 138.7 23.9 26.5 22.1 30.9

50 TEHAMA 56,666 20.0 35.3 26.7 14.8 38.6

51 MADERA 126,394 32.0 25.3 27.2 17.7 36.6

52 TULARE 379,944 87.7 23.1 28.0 22.2 33.9

53 FRESNO 811,179 187.7 23.1 28.3 24.2 32.3

54 HUMBOLDT 128,419 37.0 28.8 28.9 19.6 38.3

55 YUBA 63,983 15.7 24.5 * 29.7 * 15.0 44.5

56 SAN BERNARDINO 1,727,452 378.7 21.9 30.5 27.4 33.6

57 MERCED 215,256 52.3 24.3 32.4 23.6 41.2

58 KINGS 126,672 39.3 31.1 48.4 33.2 63.6

CALIFORNIA

POPULATION UPPER

95% CONFIDENCE LIMITSDEATHS CRUDE AGE-ADJUSTED

(AVERAGE) DEATH RATE DEATH RATE

RANK

ORDER

2000

TABLE 13

DEATHS DUE TO DIABETES



1999-2001

LOWERCOUNTY



37/87


TABLE 14: REPORTED INCIDENCE OF HEPATITIS C, 1999-2001

California Counties Ranked by Three-Year Average Crude Case Rate

The crude case rate of newly reported hepatitis C cases for California was.39 cases per 100,000 population or approximately one newly reported

hepatitis C case for every 256,066 persons. This rate was based on the1999-2001 average reported number of new cases of 135.33 and a populationof 34,653,395 as of July 1, 2000. The only reliable crude case rate was inLos Angeles County, .42 per 100,000 population; however 21 countiesreported no new incidence of hepatitis C during the three-year period.

Altogether 44 counties (one with a reliable case rate) and California as awhole met the Healthy People 2010 National Objective of 1.00 case per100,000 population.

The data in this table are not comparable to the hepatitis C data reported inprior County Health Status Profiles reports. Data in prior reports were basedon total number of reported cases, not new cases. As with other morbiditydata, undercounts may occur in many counties.

Notes:

Case rates are per 100,000 population.

* Case rate unreliable, relative standard error is greater than or equal to 23 percent.+ Standard error indeterminate, case rate based on no (zero) cases.- Upper and lower limits at the 95 percent confidence level are not calculated for no (zero) cases.

Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second bydecreasing size of the population. For purposes of this report, rates with a relative standard error greater thanor equal to 23 percent are considered unreliable. The upper and lower limits of the crude case rate at the95 percent confidence level give an indication of the precision of the estimated case rate. The wider theinterval, the less precise the rate. The upper and lower limits of the crude case rate at the 95 percentconfidence level define the range within which the case rate would probably occur in 95 out of 100independent sets of data similar to the present set. (For additional information see the Technical Notes, pages63 through 74.)

DATA SOURCES

Department of Health Services: Disease Investigation and Surveillance Branch.Department of Finance: 2000 Population Estimates with Age, Sex and Race/Ethnic Detail, December 1998.


38/87

1 SAN DIEGO 2,943,001 0.00 0.00 + - -

2 CONTRA COSTA 931,946 0.00 0.00 + - -

3 VENTURA 753,820 0.00 0.00 + - -

4 KERN 677,372 0.00 0.00 + - -5 SANTA CRUZ 260,248 0.00 0.00 + - -

6 SAN LUIS OBISPO 254,818 0.00 0.00 + - -

7 YOLO 164,010 0.00 0.00 + - -

8 NAPA 127,084 0.00 0.00 + - -

9 MADERA 126,394 0.00 0.00 + - -

10 SUTTER 82,040 0.00 0.00 + - -

11 CALAVERAS 42,041 0.00 0.00 + - -

12 LASSEN 35,959 0.00 0.00 + - -

13 AMADOR 34,853 0.00 0.00 + - -

14 PLUMAS 20,852 0.00 0.00 + - -

15 INYO 18,437 0.00 0.00 + - -

16 MARIPOSA 16,762 0.00 0.00 + - -

17 TRINITY 13,490 0.00 0.00 + - -

18 MONO 10,891 0.00 0.00 + - -

19 MODOC 10,481 0.00 0.00 + - -20 SIERRA 3,457 0.00 0.00 + - -

21 ALPINE 1,239 0.00 0.00 + - -

22 SANTA CLARA 1,763,252 0.33 0.02 * 0.00 0.08

23 SAN MATEO 747,061 0.33 0.04 * 0.00 0.20

24 ALAMEDA 1,470,155 0.67 0.05 * 0.00 0.15

25 SOLANO 399,841 0.33 0.08 * 0.00 0.37

26 SAN JOAQUIN 579,712 0.67 0.11 * 0.00 0.39

27 MARIN 248,397 0.33 0.13 * 0.00 0.59

28 RIVERSIDE 1,570,885 2.33 0.15 * 0.00 0.34

29 MERCED 215,256 0.33 0.15 * 0.00 0.68

30 SANTA BARBARA 412,071 0.67 0.16 * 0.00 0.55

31 FRESNO 811,179 1.33 0.16 * 0.00 0.44

32 ORANGE 2,833,190 4.67 0.16 * 0.02 0.31

33 SAN BERNARDINO 1,727,452 3.00 0.17 * 0.00 0.37

34 SAN FRANCISCO 792,049 2.00 0.25 * 0.00 0.60

34,653,395 135.33 0.39 0.32 0.46

35 MENDOCINO 90,442 0.33 0.37 * 0.00 1.62

36 PLACER 243,646 1.00 0.41 * 0.00 1.21

37 LOS ANGELES 9,838,861 41.33 0.42 0.29 0.55

38 IMPERIAL 154,549 0.67 0.43 * 0.00 1.47

39 SONOMA 459,258 2.00 0.44 * 0.00 1.04

40 STANISLAUS 459,025 2.00 0.44 * 0.00 1.04

41 SACRAMENTO 1,212,527 5.67 0.47 * 0.08 0.85

42 MONTEREY 401,886 2.67 0.66 * 0.00 1.46

43 SISKIYOU 45,194 0.33 0.74 * 0.00 3.24

44 SHASTA 175,777 1.67 0.95 * 0.00 2.39

1.00

45 DEL NORTE 31,155 0.33 1.07 * 0.00 4.70

46 LAKE 60,072 0.67 1.11 * 0.00 3.77

47 SAN BENITO 51,853 0.67 1.29 * 0.00 4.37

48 NEVADA 97,020 1.33 1.37 * 0.00 3.7149 BUTTE 207,158 3.67 1.77 * 0.00 3.58

50 HUMBOLDT 128,419 3.33 2.60 * 0.00 5.38

51 EL DORADO 163,197 4.33 2.66 * 0.16 5.16

52 TEHAMA 56,666 1.67 2.94 * 0.00 7.41

53 TUOLUMNE 56,125 1.67 2.97 * 0.00 7.48

54 COLUSA 20,973 0.67 3.18 * 0.00 10.81

55 TULARE 379,944 13.33 3.51 * 1.63 5.39

56 GLENN 29,298 1.67 5.69 * 0.00 14.33

57 KINGS 126,672 13.67 10.79 * 5.07 16.51

58 YUBA 63,983 13.67 21.36 * 10.04 32.68

LOWER UPPER

TABLE 14

REPORTED INCIDENCE OF HEPATITIS C

RANKED BY CRUDE CASE RATE


CRUDE 95% CONFIDENCE LIMITS

ORDER

RANK

CASE RATEPOPULATION (AVERAGE)COUNTY


CALIFORNIA

2000

1999-2001

CASES



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TABLE 15: REPORTED INCIDENCE OF AIDS

AMONG POPULATION AGES 13 YEARS AND OVER, 1999-2001California Counties Ranked by Three-Year Average Crude Case Rate

The crude case rate of reported AIDS cases for Californians aged 13 yearsand older was 16.35 cases per 100,000 population aged 13 years and over orapproximately one reported AIDS case for every 6,117 persons. This ratewas based on a 1999 to 2001 three-year average reported number of cases of4,094.67 and a population of 25,048,646 as of July 1, 2000.

Among counties with "reliable" rates, the crude case rate ranged from 78.64 inSan Francisco County to 6.69 in Stanislaus County, a difference in rates by afactor of 11.8 to 1. Six counties reported no new incidence of AIDS during thethree-year period for this age group.

Altogether 6 counties (none with reliable case rates), but not California as awhole, met the Healthy People 2010 National Objective of no more than 1.00case per 100,000 population aged 13 years and older.

Notes:

Case rates are per 100,000 population. The average number of cases excludes those with unknown countyof residence.


Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second bydecreasing size of the population. For purposes of this report, rates with a relative standard error greater thanor equal to 23 percent are considered unreliable. The upper and lower limits of the crude case rate at the95 percent confidence level give an indication of the precision of the estimated case rate. The wider theinterval, the less precise the rate. The upper and lower limits of the crude case rate at the 95 percentconfidence level define the range within which the case rate would probably occur in 95 out of 100independent sets of data similar to the present set. (For additional information see the Technical Notes, pages63 through 74.)

DATA SOURCES

Department of Health Services: Office of AIDS, AIDS Case Registry.Department of Finance: 2000 Population Estimates with Age, Sex and Race/Ethnic Detail, December 1998.


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TABLE 16: REPORTED INCIDENCE OF TUBERCULOSIS, 1999-2001California Counties Ranked by Three-Year Average Crude Case Rate

The crude case rate of reported tuberculosis cases for California was 9.85cases per 100,000 population or approximately one reported tuberculosis case

for every 10,155 persons. This rate was based on a 1999 to 2001 three-yearaverage reported number of cases of 3,412.33 and a population of 34,653,395as of July 1, 2000.

Among counties with "reliable" rates, the crude case rate ranged from 24.70 inSan Francisco County to 4.58 in Riverside County, a difference in rates bya factor of 5.4 to 1. Four counties reported no new incidence of tuberculosisduring the three-year period.

Altogether 7 counties (none with reliable case rates), but not California as awhole, met the Healthy People 2010 National Objective of no more than 1.00case per 100,000 population.

The Healthy People 2010 National Objective of 1.00 case per 100,000population reflects a decrease from the Healthy People 2000 NationalObjective of no more than 3.50 cases per 100,000 population.

Notes:



Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second bydecreasing size of the population. Of two counties with the same case rate, the one with the larger populationis ranked ahead of the smaller. For purposes of this report, rates with a relative standard error greater thanor equal to 23 percent are considered unreliable. The upper and lower limits of the crude case rate at the95 percent confidence level give an indication of the precision of the estimated case rate. The wider theinterval, the less precise the rate. The upper and lower limits of the crude case rate at the 95 percentconfidence level define the range within which the case rate would probably occur in 95 out of 100

independent sets of data similar to the present set. (For additional information see the Technical Notes, pages63 through 74.)

DATA SOURCES

Department of Health Services: Division of Communicable Disease Control.Department of Finance: 2000 Population Estimates with Age, Sex and Race/Ethnic Detail, December 1998.


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1 TRINITY 13,490 0.00 0.00 + - -

2 MONO 10,891 0.00 0.00 + - -

3 SIERRA 3,457 0.00 0.00 + - -

4 ALPINE 1,239 0.00 0.00 + - -5 CALAVERAS 42,041 0.33 0.79 * 0.00 3.48

6 AMADOR 34,853 0.33 0.96 * 0.00 4.20

7 PLACER 243,646 2.33 0.96 * 0.00 2.19

8 DEL NORTE 31,155 0.33 1.07 * 0.00 4.70

9 GLENN 29,298 0.33 1.14 * 0.00 5.00

10 NEVADA 97,020 1.33 1.37 * 0.00 3.71

11 SISKIYOU 45,194 0.67 1.48 * 0.00 5.02

12 PLUMAS 20,852 0.33 1.60 * 0.00 7.03

13 TUOLUMNE 56,125 1.00 1.78 * 0.00 5.27

14 INYO 18,437 0.33 1.81 * 0.00 7.95

15 LASSEN 35,959 0.67 1.85 * 0.00 6.30

16 EL DORADO 163,197 3.33 2.04 * 0.00 4.24

17 BUTTE 207,158 4.33 2.09 * 0.12 4.06

18 NAPA 127,084 2.67 2.10 * 0.00 4.6219 MENDOCINO 90,442 2.33 2.58 * 0.00 5.89

20 SHASTA 175,777 4.67 2.65 * 0.25 5.06

21 TEHAMA 56,666 1.67 2.94 * 0.00 7.41

22 SONOMA 459,258 14.33 3.12 * 1.51 4.74

23 SANTA CRUZ 260,248 8.33 3.20 * 1.03 5.38

24 LAKE 60,072 2.00 3.33 * 0.00 7.94

25 SAN LUIS OBISPO 254,818 8.67 3.40 * 1.14 5.67

26 MARIPOSA 16,762 0.67 3.98 * 0.00 13.52

27 RIVERSIDE 1,570,885 72.00 4.58 3.52 5.64

28 YOLO 164,010 7.67 4.67 * 1.37 7.98

29 TULARE 379,944 18.00 4.74 * 2.55 6.93

30 COLUSA 20,973 1.00 4.77 * 0.00 14.11

31 MARIN 248,397 12.00 4.83 * 2.10 7.56

32 STANISLAUS 459,025 23.00 5.01 2.96 7.06

33 HUMBOLDT 128,419 7.00 5.45 * 1.41 9.49

34 MERCED 215,256 12.00 5.57 * 2.42 8.73

35 SAN BERNARDINO 1,727,452 100.00 5.79 4.65 6.92

36 SANTA BARBARA 412,071 24.67 5.99 3.62 8.35

37 SUTTER 82,040 5.00 6.09 * 0.75 11.44

38 MODOC 10,481 0.67 6.36 * 0.00 21.63

39 VENTURA 753,820 52.67 6.99 5.10 8.87

40 KINGS 126,672 9.67 7.63 * 2.82 12.44

41 SOLANO 399,841 31.33 7.84 5.09 10.58

42 KERN 677,372 53.33 7.87 5.76 9.99

43 SAN MATEO 747,061 62.00 8.30 6.23 10.37

44 SAN BENITO 51,853 4.33 8.36 * 0.49 16.23

45 YUBA 63,983 5.67 8.86 * 1.56 16.15

46 MADERA 126,394 11.33 8.97 * 3.75 14.19

47 ORANGE 2,833,190 256.67 9.06 7.95 10.17

48 SACRAMENTO 1,212,527 115.67 9.54 7.80 11.28

34,653,395 3,412.33 9.85 9.52 10.1849 CONTRA COSTA 931,946 93.33 10.01 7.98 12.05

50 MONTEREY 401,886 40.33 10.04 6.94 13.13

51 SAN DIEGO 2,943,001 307.67 10.45 9.29 11.62

52 SAN JOAQUIN 579,712 65.67 11.33 8.59 14.07

53 FRESNO 811,179 96.67 11.92 9.54 14.29

54 LOS ANGELES 9,838,861 1,173.67 11.93 11.25 12.61

55 SANTA CLARA 1,763,252 231.33 13.12 11.43 14.81

56 ALAMEDA 1,470,155 231.67 15.76 13.73 17.79

57 IMPERIAL 154,549 29.67 19.20 12.29 26.10

58 SAN FRANCISCO 792,049 195.67 24.70 21.24 28.17

CALIFORNIA

2000

1999-2001

YEAR 2010 NATIONAL OBJECTIVE: 1.00


CASES

LOWER UPPER

TABLE 16

REPORTED INCIDENCE OF TUBERCULOSIS

RANKED BY THREE-YEAR AVERAGE CRUDE CASE RATE



ORDER

RANK



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TABLE 17: REPORTED INCIDENCE OF CHLAMYDIA, 1999-2001

California Counties Ranked by Three-Year Average Crude Case Rate

The crude case rate of reported chlamydia cases for California was 271.59cases per 100,000 population or approximately one reported chlamydia casefor every 368 persons. This rate was based on a 1999 to 2001 three-yearaverage reported number of cases of 94,116.33 and a population of34,653,395 as of July 1, 2000.

Among counties with "reliable" rates, the crude case rate ranged from 465.08in Fresno County to 46.78 in Calaveras County, a difference in rates by afactor of 10 to 1.

Prevalence data are not available in California to evaluate the Healthy People

2010 National Objective of no more than 3 percent testing positive in thepopulation aged 15 to 24 years.Notes:


* Case rate unreliable, relative standard error is greater than or equal to 23 percent.

Counties were rank ordered first by increasing case rate (calculated to 15 decimal places), second by

decreasing size of the population. Of two counties with the same case rate, the one with the larger populationis ranked ahead of the smaller. For purposes of this report, rates with a relative standard error greater thanor equal to 23 percent are considered unreliable. The upper and lower limits of the crude case rate at the95 percent confidence level give an indication of the precision of the estimated case rate. The wider theinterval, the less precise the rate. The upper and lower limits of the crude case rate at the 95 percentconfidence level define the range within which the case rate would probably occur in 95 out of 100independent sets of data similar to the present set. (For additional information see the Technical Notes, pages63 through 74.)

DATA SOURCES

Department of Health Services: Division of Communicable Disease Control.

Department of Finance: 2000 Population Estimates with Age, Sex and Race/Ethnic Detail, December 1998.


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TABLE 18: REPORTED INCIDENCE OF PRIMARY ANDSECONDARY SYPHILIS, 1999-2001

The crude case rate of reported primary and secondary syphilis cases for California was 1.11 casesper 100,000 population or approximately one reported syphilis case for every 90,086 personTable 18 shows only those counties where at least one case was reported. This rate was based ona 1999 to 2001 three-year average reported number of cases of 384.67 and a population of

34,653,395 as of July 1, 2000.

Among counties with "reliable" rates, the crude case rate ranged from 9.26 inSan Francisco County to .89 in San Diego County, a difference in rates by a factor of 10.4 to 1.

Altogether 31 counties (none with reliable case rates),but not California as a whole, met the HealthyPeople 2010 National Objective of .20 cases per 100,000 population. Twenty-five counties (notshown on Table 18) had no reported cases during the three-year period.

(See Table 16 for Notes and Data Sources footnote.)

26 SANTA CRUZ 260,248 0.33 0.13 * 0.00 0.56

27 SONOMA 459,258 0.67 0.15 * 0.00 0.49

28 BUTTE 207,158 0.33 0.16 * 0.00 0.71

29 TULARE 379,944 0.67 0.18 * 0.00 0.60

30 SACRAMENTO 1,212,527 2.33 0.19 * 0.00 0.44

31 YOLO 164,010 0.33 0.20 * 0.00 0.89

HEALTHY PEOPLE 2010 NATIONAL OBJECTIVE: 0.20

32 NAPA 127,084 0.33 0.26 * 0.00 1.15

33 VENTURA 753,820 2.00 0.27 * 0.00 0.63

34 PLACER 243,646 0.67 0.27 * 0.00 0.93

35 SANTA CLARA 1,763,252 5.33 0.30 * 0.05 0.56

36 MONTEREY 401,886 1.33 0.33 * 0.00 0.89

37 SOLANO 399,841 1.33 0.33 * 0.00 0.90

38 NEVADA 97,020 0.33 0.34 * 0.00 1.51

39 SANTA BARBARA 412,071 1.67 0.40 * 0.00 1.02

40 STANISLAUS 459,025 2.33 0.51 * 0.00 1.16

41 YUBA 63,983 0.33 0.52 * 0.00 2.29

42 SAN BERNARDINO 1,727,452 9.00 0.52 * 0.18 0.86

43 MADERA 126,394 0.67 0.53 * 0.00 1.79

44 RIVERSIDE 1,570,885 8.33 0.53 * 0.17 0.89

45 SAN MATEO 747,061 5.00 0.67 * 0.08 1.26

46 CONTRA COSTA 931,946 6.67 0.72 * 0.17 1.26

47 KINGS 126,672 1.00 0.79 * 0.00 2.34

48 SAN DIEGO 2,943,001 26.33 0.89 0.55 1.24

49 FRESNO 811,179 7.33 0.90 * 0.25 1.56

50 MARIN 248,397 2.33 0.94 * 0.00 2.14

51 ALAMEDA 1,470,155 15.67 1.07 * 0.54 1.59

34,653,395 384.67 1.11 1.00 1.22

52 ORANGE 2,833,190 33.00 1.16 0.77 1.56

53 SAN JOAQUIN 579,712 7.67 1.32 * 0.39 2.26

54 KERN 677,372 9.67 1.43 * 0.53 2.33

55 LOS ANGELES 9,838,861 152.67 1.55 1.31 1.80

56 MARIPOSA 16,762 0.33 1.99 * 0.00 8.74

57 MERCED 215,256 5.33 2.48 * 0.37 4.58

58 SAN FRANCISCO 792,049 73.33 9.26 7.14 11.38

COUNTY

CASES

CALIFORNIA

20001999-2001

CASE RATEPOPULATION (AVERAGE) LOWER UPPER




ORDER

RANK


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TABLE 19: REPORTED INCIDENCE OF MEASLES, 1999-2001

The crude case rate of reported measles cases for California was 0.07 cases per 100,000population or approximately one reported measles case for every 1,368,077 persons.Table 19 shows only those counties where at least one case was reported. This rate was

based on a 1999 to 2001 three-year average reported number of cases of 25.33 and apopulation of 34,653,395 as of July 1, 2000. Of the 58 counties, none had a "reliable" rate.

The Healthy People 2010 National Objective for incidence of reported measles cases iszero cases, which is equivalent to a case rate of 0.00 per 100,000 population.

Altogether 44 counties (not shown on Table 19) met the Healthy People 2010 NationalObjective of no reported cases of measles during the three-year period. Many of theremaining counties were so close to zero, that for all practical purposes, the HealthyPeople 2010 National Objective has been met by these counties as well.

(See Table 16 for Notes and Data Sources footnote.)

45 SAN BERNARDINO 1,727,452 0.33 0.02 * 0.00 0.08

46 RIVERSIDE 1,570,885 0.33 0.02 * 0.00 0.09

47 SACRAMENTO 1,212,527 0.33 0.03 * 0.00 0.12

48 LOS ANGELES 9,838,861 5.33 0.05 * 0.01 0.10

34,653,395 25.33 0.07 0.04 0.10

49 MONTEREY 401,886 0.33 0.08 * 0.00 0.36

50 VENTURA 753,820 0.67 0.09 * 0.00 0.30

51 SAN DIEGO 2,943,001 2.67 0.09 * 0.00 0.20

52 ALAMEDA 1,470,155 1.67 0.11 * 0.00 0.29

53 ORANGE 2,833,190 3.33 0.12 * 0.00 0.24

54 CONTRA COSTA 931,946 1.33 0.14 * 0.00 0.39

55 SAN MATEO 747,061 1.33 0.18 * 0.00 0.48

56 MARIN 248,397 0.67 0.27 * 0.00 0.91

57 SAN FRANCISCO 792,049 3.67 0.46 * 0.00 0.94

58 SANTA CRUZ 260,248 3.33 1.28 * 0.00 2.66

CALIFORNIA

LOWER UPPER

TABLE 19

REPORTED INCIDENCE OF MEASLES




ORDER

RANK 2000

1999-2001



CASES


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TABLE 20A: INFANT MORTALITY, ALL RACE/ETHNIC GROUPS,1997, 1999, 2000

California Counties Ranked by Three-Year Average Birth Cohort Infant Death Rate

The birth cohort infant death rate for California was 5.7 deaths per 1,000 livebirths, a risk of dying equivalent to approximately one infant death for every176 births. This rate was based on the 2,985.3 infant deaths among524,591.3 live births, the three-year average for the years 1997, 1999, and2000.

Among counties with "reliable" rates, the birth cohort infant death rate rangedfrom 7.5 in Stanislaus and San Bernardino Counties to 4.3 in San FranciscoCounty, a difference in rates by a factor of 1.7 to 1.

Altogether 12 counties (1 with a reliable rate), but not California as a whole,met the Healthy People 2010 National Objective of no more than 4.5 infantdeaths per 1,000 birth cohort live births.

Notes:

Infant deaths are deaths that occurred during the first year of life. Birth cohort infant death rates are per 1,000live births. The birth cohort infant death rate is based upon births during a calendar year (a cohort) trackedindividually for 365 days to determine whether or not death occurred. Thus, the deaths in the numerator ofa birth cohort infant death rate are the records of the same infants as the births in the denominator. Birthcohort infant death rates, like population crude death rates, show the true risk of dying, and also, like

age-adjusted population death rates, allow direct comparisons between counties.

Due to staffing shortages within the Center for Health Statistics, a birth cohort file was not created for 1998.Therefore, three-year birth cohort averages were created using the data years 1997, 1999, and 2000. Cautionshould be exercised when using this three-year average infant mortality rate for trend analysis.


Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places),second by decreasing size of the total number of live births. Infant mortality data by race/ethnicity is basedon the mothers race/ethnicity reported on the birth record, and are grouped according to the methodology

used by the Demographic Research Unit of the Department of Finance to compile population estimates. Forpurposes of this report, rates with a relative standard error greater than or equal to 23 percent are consideredunreliable. The upper and lower limits of the birth cohort death rate at the 95 percent confidence levelindicate the precision of the estimated death rate. The wider the interval, the less precise the death rate. Theupper and lower limits define the range within which the death rate would probably occur in 95 out of 100independent sets of data similar to the present set. (For additional information see the Technical Notes,pages 63 through 74.)

DATA SOURCES

Department of Health Services: Birth Cohort-Perinatal Outcome Files, 1997 1999, 2000.


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1 SIERRA 15.00 0.00 0.0 + - -

2 ALPINE 9.33 0.00 0.0 + - -

3 CALAVERAS 320.33 0.67 2.1 * 0.0 7.1

4 NEVADA 775.67 2.00 2.6 * 0.0 6.25 AMADOR 256.33 0.67 2.6 * 0.0 8.8

6 EL DORADO 1,643.67 4.67 2.8 * 0.3 5.4

7 NAPA 1,496.33 4.67 3.1 * 0.3 5.9

8 MARIN 2,709.00 9.33 3.4 * 1.2 5.7

9 SISKIYOU 433.00 1.67 3.8 * 0.0 9.7

10 GLENN 399.33 1.67 4.2 * 0.0 10.5

11 SAN FRANCISCO 8,324.33 36.00 4.3 2.9 5.7

12 PLUMAS 147.67 0.67 4.5 * 0.0 15.4

13 SANTA BARBARA 5,655.67 26.00 4.6 2.8 6.4

14 ORANGE 46,993.67 219.33 4.7 4.0 5.3

15 SONOMA 5,493.00 26.00 4.7 2.9 6.6

16 SAN MATEO 10,200.67 48.33 4.7 3.4 6.1

17 PLACER 2,869.67 13.67 4.8 * 2.2 7.3

18 SAN LUIS OBISPO 2,427.67 11.67 4.8 * 2.0 7.6

19 CONTRA COSTA 12,696.33 62.67 4.9 3.7 6.220 MERCED 3,714.00 18.67 5.0 * 2.7 7.3

21 SANTA CLARA 26,765.33 135.00 5.0 4.2 5.9

22 SAN BENITO 912.67 4.67 5.1 * 0.5 9.8

23 IMPERIAL 2,472.33 13.00 5.3 * 2.4 8.1

24 MONTEREY 6,780.33 35.67 5.3 3.5 7.0

25 SANTA CRUZ 3,503.67 18.67 5.3 * 2.9 7.7

26 SOLANO 5,636.00 30.33 5.4 3.5 7.3

27 ALAMEDA 21,162.67 115.00 5.4 4.4 6.4

28 MONO 121.67 0.67 5.5 * 0.0 18.6

29 BUTTE 2,235.67 12.33 5.5 * 2.4 8.6

30 YOLO 2,165.00 12.00 5.5 * 2.4 8.7

31 LOS ANGELES 158,575.00 884.33 5.6 5.2 5.9

32 SUTTER 1,168.33 6.67 5.7 * 1.4 10.0

33 LASSEN 292.00 1.67 5.7 * 0.0 14.4

34 VENTURA 11,498.67 65.67 5.7 4.3 7.1

35 SAN DIEGO 43,600.00 249.33 5.7 5.0 6.4

524,591.3 2,985.3 5.7 5.5 5.9

36 MADERA 2,016.67 11.67 5.8 * 2.5 9.1

37 HUMBOLDT 1,433.67 8.67 6.0 * 2.0 10.1

38 TULARE 6,984.00 43.33 6.2 4.4 8.1

39 LAKE 575.67 3.67 6.4 * 0.0 12.9

40 MENDOCINO 1,040.33 6.67 6.4 * 1.5 11.3

41 SAN JOAQUIN 9,058.00 58.33 6.4 4.8 8.1

42 SACRAMENTO 17,749.67 115.33 6.5 5.3 7.7

43 RIVERSIDE 23,898.67 158.33 6.6 5.6 7.7

44 TEHAMA 649.00 4.33 6.7 * 0.4 13.0

45 KINGS 2,136.33 14.33 6.7 * 3.2 10.2

46 SHASTA 1,891.67 13.00 6.9 * 3.1 10.6

47 KERN 11,444.33 81.33 7.1 5.6 8.7

48 TRINITY 91.67 0.67 7.3 * 0.0 24.7

49 FRESNO 14,132.67 103.33 7.3 5.9 8.7

50 INYO 182.33 1.33 7.3 * 0.0 19.7

51 STANISLAUS 7,050.00 52.67 7.5 5.5 9.5

52 SAN BERNARDINO 28,458.00 212.67 7.5 6.5 8.5

53 MODOC 82.00 0.67 8.1 * 0.0 27.6

54 COLUSA 324.00 2.67 8.2 * 0.0 18.1

55 DEL NORTE 312.67 2.67 8.5 * 0.0 18.8

56 YUBA 1,036.00 9.67 9.3 * 3.4 15.2

57 TUOLUMNE 445.00 4.67 10.5 * 1.0 20.0

58 MARIPOSA 129.00 2.00 15.5 * 0.0 37.0

CALIFORNIA

THREE-YEAR AVERAGE BIRTH COHORT

INFANT


95% CONFIDENCE LIMITS

LOWER UPPER

TABLE 20A

INFANT MORTALITY, ALL RACE/ETHNIC GROUPS

RANKED BY THREE-YEAR AVERAGE BIRTH COHORT INFANT DEATH RATE

CALIFORNIA COUNTIES, 1997, 1999, 2000

RANK LIVE INFANT

ORDER BIRTHS DEATHS DEATH RATECOUNTY



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TABLE 20B: ASIAN/OTHER INFANT MORTALITY, 1997, 1999, 2000


The Asian/Other birth cohort infant death rate for California was 5.3 deaths per1,000 live births, a risk of dying equivalent to approximately one infant death

for every 190 births. This rate was based on the 339.3 infant deaths among64,363.7 live births, the three-year average for the years 1997, 1999, and2000.

Among counties with "reliable" rates, the birth cohort infant death rate rangedfrom 5.1 in San Diego County to 4.3 in Alameda County, a difference in ratesby a factor of 1.2 to 1.

A Healthy People 2010 National Objective for an Asian/Other birth cohort

infant death rate has not been established.

Notes:

Infant deaths are deaths that occurred during the first year of life. Birth cohort infant death rates are per 1,000live births. The birth cohort infant death rate is based upon births during a calendar year (a cohort) trackedindividually for 365 days to determine whether or not death occurred. Thus, the deaths in the numerator ofa birth cohort infant death rate are the records of the same infants as the births in the denominator. Birthcohort infant death rates, like population crude death rates, show the true risk of dying, and also, likeage-adjusted population death rates, allow direct comparison between counties.

Due to staffing shortages within the Center for Health Statistics, a birth cohort file was not created for 1998.

Therefore, three-year birth cohort averages were created using the data years 1997, 1999, and 2000. Cautionshould be exercised when using this three-year average infant mortality rate for trend analysis.

* Death rate unreliable, relative standard error is greater than or equal to 23 percent.+ Standard error indeterminate, case rate based on no (zero) deaths.- Upper and lower limits at the 95 percent confidence level are not calculated for no (zero) deaths.

Counties were rank ordered first by increasing birth cohort death rate (calculated to 15 decimal places),second by decreasing size of the total number of live births. Infant mortality data by race/ethnicity is basedon the mothers race/ethnicity reported on the birth record, and are grouped according to the methodologyused by the Demographic Research Unit of the Department of Finance to compile population estimates. Forpurposes of this report, rates with a relative standard error greater than or equal to 23 percent are consideredunreliable. The upper and lower limits of the birth cohort death rate at the 95 percent confidence level

indicate the precision of the estimated death rate. The wider the interval, the less precise the death rate. Theupper and lower limits define the range within which the death rate would probably occur in 95 out of 100independent sets of data similar to the present set. (For additional information see the Technical Notes,pages 63 through 74.)

DATA SOURCES

Department of Health Services: Birth Cohort-Perinatal Outcome Files, 1997, 1999, 2000.


50/87


51/87


TABLE 20C: BLACK INFANT MORTALITY, 1997, 1999, 2000


The Black birth cohort infant death rate for California was 12.6 deaths per1,000 live births, a risk of dying equivalent to approximately one infant death

for every 79 births. This rate was based on the 437.3 deaths among the34,628.3 live births, the three-year average for the years 1997, 1999, and2000.

Among counties with "reliable" rates, the birth cohort infant death rate forBlacks ranged from 15.6 in Riverside County to 11.6 in Alameda County, adifference in rates by a factor of 1.3 to 1.

A Healthy People 2010 National Objective for a Black birth cohort infant death

rate has not been established.

Notes:

Infant deaths are deaths that occurred during the first year of life. Birth cohort infant death rates are per 1,000live births. The birth cohort infant death rate is based upon births during a calendar year (a cohort) trackedindividually for 365 days to determine whether or not death occurred. Thus, the deaths in the numerator ofa birth cohort infant death rate are the records of the same infants as the births in the denominator. Birthcohort infant death rates, like population crude death rates, show the true risk of dying and also, likeage-adjusted population death rates, allow direct comparisons between counties.

Due to staffing shortages within the Center for Health Statistics, a birth cohort file was not created for 1998.Therefore, three-year birth cohort averages were created using the data years 1997, 1999, and 2000. Caution

should be exercised when using this three-year average infant mortality rate for trend analysis.

* Death rate unreliable, relative standard error is greater than or equal to 23 percent.+ Standard error indeterminate, death rate based on no (zero) d

Documents

California County Health Status Profiles 2003